Abstract
BackgroundThe study of the relationship between residential environment and health at micro area level has a long time been hampered by a lack of micro-scale data. Nowadays data is registered at a much more detailed scale. In combination with Geographic Information System (GIS)-techniques this creates opportunities to look at the relationship at different scales, including very local ones. The study illustrates the use of a ‘bespoke environment’ approach to assess the relationship between health and socio-economic environment.MethodsWe created these environments by buffer-operations and used micro-scale data on 6-digit postcode level to describe these individually tailored areas around survey respondents in an accurate way. To capture the full extent of area effects we maximized variation in socio-economic characteristics between areas. The area effect was assessed using logistic regression analysis.ResultsAlthough the contribution of the socio-economic environment in the explanation of health was not strong it tended to be stronger at a very local level. A positive association was observed only when these factors were measured in buffers smaller than 200 meters. Stronger associations were observed when restricting the analysis to socioeconomically homogeneous buffers. Scale effects proved to be highly important but potential boundary effects seemed not to play an important role. Administrative areas and buffers of comparable sizes came up with comparable area effects.ConclusionsThis study shows that socio-economic area effects reveal only on a very micro-scale. It underlines the importance of the availability of micro-scale data. Through scaling, bespoke environments add a new dimension to study environment and health.
Highlights
Since the mid-1990s, a great deal of research has been conducted with the aim to assess area effects on health [1]
A key aim in this research has been to demonstrate the independent effect, if any, that area-level socioeconomic factors have on health
The health effects shown in observational studies often disappear after extensive adjustment for individual socioeconomic characteristics [2,3,4,5]. An explanation for this lack of strong association may be that area effects are difficult to measure
Summary
Since the mid-1990s, a great deal of research has been conducted with the aim to assess area effects on health (for an overview, see Smyth) [1]. The health effects shown in observational studies often disappear after extensive adjustment for individual socioeconomic characteristics (see for example, Robert, Pickett et al, Reijneveld, Yen et al.) [2,3,4,5]. An explanation for this lack of strong association may be that area effects are difficult to measure. The study of the relationship between residential environment and health at micro area level has a long time been hampered by a lack of micro-scale data. The study illustrates the use of a ‘bespoke environment’ approach to assess the relationship between health and socio-economic environment
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